EXPLORATORY ANALYSIS OF URINE PO2 PERI-PROCEDURAL KINETICS AND CI-AKI PROGNOSTIC ABILITIES IN PATIENTS UNDERGOING PCI.

Q3 Medicine

Critical Pathways in Cardiology Pub Date : 2024-05-23 DOI:10.1097/HPC.0000000000000367

Georgios Chalikias, Dimitrios Stakos, Theodoros Kostakis, Choulia Nalmbant, Belkis Malkots, Vasilios Koutroulos, Kalliopi Theodoridou, Adina Thomaidis, Dimitrios Tziakas

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Abstract

Novel contrast-induced acute kidney injury (CI-AKI) biomarkers are needed to detect earlier and with greater precision the pathophysiological changes in renal medulla associated with kidney damage. We prospectively assessed the kinetics of urine oxygen tension (PO2) in control healthy individuals, and its prognostic ability for CI-AKI in patients undergoing percutaneous coronary intervention (PCI). We enrolled 202 consecutive patients (78% men, mean age 66±10 years) treated with elective or urgent PCI. PO2 was measured using a point-of-care (POC) standard blood gas analyzer at 3 time points (baseline, post -within 3 hours- PCI and at 24 hours post PCI) in urine samples. CI-AKI was defined as an increase of ≥25% or ≥0.5 mg/dl in pre-PCI serum creatinine at 48 hours post PCI. Between baseline and post-PCI measurements, patients without CI-AKI showed a decrease of -37 (36) mmHg in PO2 urine levels whereas patients with CI-AKI showed a decrease of only -23 (38) mmHg. (P=0.014). Using ROC analysis, percentage change in urine PO2 immediately after PCI relative to baseline levels, significantly predicted CI-AKI (AUC 0.804 95%CI 0.717-0.892). A significant drop in urine oxygen tension appears as a normal response of the kidney medulla to an acute insult (contrast media) immediately post PCI with a recovery to baseline levels 24 hours later. Absence or attenuation of this drop in urine oxygen tension could predict CI-AKI earlier and more precisely.

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对接受心肺复苏术的患者在术前尿 PS2 动力学和 Ci-aki 预后能力的探索性分析。

需要新型造影剂诱导的急性肾损伤（CI-AKI）生物标志物来更早更精确地检测与肾损伤相关的肾髓质病理生理变化。我们前瞻性地评估了对照健康人的尿氧张力（PO2）动力学及其对接受经皮冠状动脉介入治疗（PCI）患者的 CI-AKI 的预后能力。我们连续招募了 202 名接受择期或紧急 PCI 治疗的患者（78% 为男性，平均年龄为 66±10 岁）。在 3 个时间点（基线、PCI 术后 3 小时内、PCI 术后 24 小时）使用床旁 (POC) 标准血气分析仪测量尿样中的 PO2。CI-AKI定义为PCI后48小时PCI前血清肌酐增加≥25%或≥0.5 mg/dl。在基线和PCI术后测量之间，无CI-AKI患者的尿液PO2水平下降了-37（36）mmHg，而CI-AKI患者仅下降了-23（38）mmHg。(P=0.014).通过 ROC 分析，PCI 后尿液 PO2 相对于基线水平的百分比变化可显著预测 CI-AKI（AUC 0.804 95%CI 0.717-0.892）。尿氧张力的明显下降是肾髓质对 PCI 术后即刻发生的急性损伤（造影剂）的正常反应，24 小时后会恢复到基线水平。尿氧张力不下降或下降幅度减小可更早更准确地预测 CI-AKI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Pathways in Cardiology Medicine-Medicine (all)

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Critical Pathways in Cardiology provides a single source for the diagnostic and therapeutic protocols in use at hospitals worldwide for patients with cardiac disorders. The Journal presents critical pathways for specific diagnoses—complete with evidence-based rationales—and also publishes studies of these protocols" effectiveness.